Dermal fillers are excellent for mid face volumizing and low face volume loss. This area of the face has thin, unforgiving skin. The dermal fillers by nature are meant to draw in water making them hydrophilic. The combination of thin unforgiving skin along with a "water binding" dermal filler is that you can be left with fluid pockets that do not go away unless injected with a hyaluronidase. Even after injection of this dermal filler dissolving agent, the prediction of where and how much dermal filler it will remove is completely unpredictable.
Structural fat grafting, when performed by an experienced plastic surgeon using specialized tools can create a very bautiful and natural results. It is imortant to view dozens of photos weeks and then months after the procedure is performed.
Different doctors are comfortable injecting different fillers. Belotero is supposed to have less Tyndall effect when injected more superficially. However, every patient is different - as it seems you are describing. In many cases, Restylane or Juvederm under the eyes is very successful without tyndall effect. I stock and inject all fillers and customize my technique for the individual patient's needs. Some patients need more volume while others need fine line filling - while others need a combination of both.
Belotero may not be a perfect filler, but it is the best, by far, for injection into the areas that require superficial placement. However, like any other HA filler it can cause some tissue edema which in some situations might be similar in appearance to tindel.
Belotero and Restylane can be used under the eye area. I use both but it depends on the depth of the injection. It is best to consult an expert with these injections. Best, Dr. Green
Thank you for you question. Not all doctors are switching to Belotero for under eye injections. There is no specific advantage to this filler over Restylane. All of the problems experienced with other fillers occur with Belotero also.
Thanks for your question. We have several fillers that are available in the US and Belotero is one of the
newest here – although it has been available around the world for many years now. Experience from the
outside the US injectors has shown that Belotero works very nicely in the tear troughs and around the eye
area in most people that receive the injections. There is always the risk of a Tyndall effect if any of the
filler injections are not given correctly, so please make sure that you have these injections in the offices of
a board-certified dermatologist or plastic surgeon as they know the fillers the best and have the most
knowledge of the anatomy of what needs to be treated. Tyndall effects can be treated with hyaluronidase
if needed to dissolve the filler if this occurs. But Belotero, in the right hands, is a great filler when given
Belotero is an excellent filler for thin areas of skin such as the undereye hollows.
The HA fillers that are used for the tear trough deformities can cause the Tyndall effect. Belotero is a very good product and when used in the right patient under the right circumstances should give a great cosmetic effect. Improper placement using any of the other HA fillers or Belotero can cause this problem.
Hyaluronic acids fillers are a fine suspension of polysaccharide polymers
that are differentiated based on their degree of crosslinking, concentrations,
gel hardness (G prime), viscosity, and particle size. Fillers with a high
degree of crosslinking, high G prime, and high viscosity tend to stick together
in boluses and, thus, tend to be used as deep fillers that are used for volumizing.
If these fillers are injected superficially, light strikes the bolus of material
and is scattered by the particles of HA, creating a blue hue that is called the
effect. The effect requires a bolus of filler with a high enough
concentration of HA to scatter the light. Belotero has a low G prime, low viscosity,
and variable crosslinking that allow the material to diffuse into the tissues
more easily then other fillers - helping the material to spread out. When Belotero
is injected correctly, there is no bolus of HA to scatter the
light and, thus, no blue color. A detailed examination will help delineate the best treatment option. A formal consultation with a plastic surgeon is the next best step.
When superficial placement is needed, a filler that flows is needed as well as one that is not " lifting". Boletero and Restylane are preferred. I have seen a Tindal effect with Juvederm. Restylane is releasing it's "silk" line next month. It is used worldwide. Some practitioners will dilute their filler with lidocaine with epinephrine to decrease bruising and get a better "flow".
Hope this helps